Antibiotic Overuse: Are You Guilty?

Experts at the Centers for Disease Control and Prevention (CDC, 2010) warn that about half of antibiotics prescribed in the US are unnecessary or inappropriate, and overuse has helped create bacteria that are resistant to the drugs used to fight them.

Most strains of antibiotic-resistant bacteria are found in healthcare settings, such as hospitals and nursing homes. Yet superbugs, including MRSA (methicillin-resistant staphylococcus aureus) are now being discovered more frequently in community settings such as health clubs, schools, and the workplace. Community-associated MRSA (CA-MRSA), a strain that affects healthy people outside of hospitals, made headlines in 2008 when it killed a Florida high school football player.

Other infections that resist antibiotic treatment include:
• E. coli: A new strain, ST131, was a major cause of serious resistant infections in the United States in 2007 (CDC, 2010). According to the study completed in 2007, this strain will become almost untreatable if it gains one more resistance gene.
• Gonorrhea: Cephalosporins are the only  remaining class of antibiotics available to treat this sexually transmitted disease.
• Extensive drug-resistant tuberculosis (XDR-TB): While many TB strains resist at least one antibiotic, XDR-TB is resistant to virtually all available antibiotics.

It appears that antibiotic resistance has two main causes: overuse (over-prescribing) and the inappropriate use of antibiotics to promote growth in livestock. According to the CDC, approximately six billion prescriptions are written annually in the US, and about half of these are for antibiotics. Of the prescribed antibiotics, about 50 percent  are inappropriately used. Second, livestock such as chickens, cows and pigs are fed massive amounts of antibiotics, mainly to spur growth. Earlier this year, concerns about antibiotic resistance led the FDA to recommend that farmers stop using antibiotics to promote growth in livestock.

To protect the effectiveness of antibiotics, the CDC recommends the following:
• Educate patients to take the antibiotic exactly as prescribed, and finish the prescribed course even after symptoms resolve, to prevent the development of antibiotic resistance.
• Instruct patients to dispose of any leftover antibiotics, and to never share prescription drugs with family members or others.
• Educate patients on the futility of taking antibiotics to treat influenza.
• A new study published in November 2010 in the Journal of the American Medical Association (AMA) recommends the “watch and wait” method for managing pediatric ear infections, since most are viral in origin.

The CDC is urging Americans to use antibiotics sparingly and appropriately to help prevent the global problem of antibiotic resistance. In November 2010, the CDC launched a new health promotion program, known as “Get Smart: Know When Antibiotics Work” to raise public awareness of the risks involved with the inappropriate use of antibiotic therapy, in an effort to fight the rise of deadly "superbugs."

The US Food and Drug Administration (FDA), numerous national medical and scientific associations, and state and local health departments have collaborated on this initiative. The message is clear: We all need to work together to prevent the spread of antibiotic resistance. Are you playing your part? For additional information, resources and educational tools, visit: http://www.cdc.gov/getsmart/